"If we can remove the cost barrier, folks are going to engage more because it's not standing in the way of going to get the care that they need or even preventive care." - Trey Smith

High healthcare deductibles were sold to employers as a way to create better "consumers" of healthcare. My guest this week, Trey Smith of Hub International, argues that they've been a failed experiment that has done more harm than good. Instead of creating smarter shoppers, high deductibles have become a massive barrier to care, causing employees to delay or avoid necessary treatment altogether.

In this episode, Trey breaks down the alternative: first dollar coverage.

We discuss how innovative plan designs with zero deductibles can actually lower an employer's overall claim spend over time by encouraging early intervention and proactive care. He shares data showing that while utilization spikes initially, long-term costs come down significantly as members get the care they need when they need it.

This conversation is a perfect example of why the benefits consultant's role is shifting from simply brokering insurance to designing strategic solutions that solve real problems for employees and employers. I hope you'll tune in!

Chapters:

(00:00:00) High Healthcare Deductibles Are A Failed Experiment

(00:26:16) The Risk of Innovation vs. The Risk of the Status Quo

(00:29:59) The Problem: High Deductibles as a Barrier to Care

(00:34:10) The Solution: "First Dollar" Coverage

(00:38:22) Simplifying the Healthcare Experience

(00:52:17) How Data is Making New Plan Designs Possible

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"I can look for something on Amazon and have it shipped to my door tomorrow... so why wouldn't employees want a similar experience with their healthcare?" - Amanda Volner

Can artificial intelligence actually make healthcare feel more human?

Amanda Volner, AVP of Broker Partnerships at Healthee, joins the show for a deep dive into the real role of AI in the benefits industry. We discuss how artificial intelligence is a powerful tool to augment our abilities, but why uniquely human skills like critical thinking, building relationships, and understanding "the question behind the question" are more valuable than ever.

Amanda breaks down how Healthee is using AI to create "hyper-personalized" healthcare experiences for members, from navigating benefits to finding cost-effective pharmacy solutions. We explore how modern engagement platforms are essential for communicating with a decentralized workforce and how AI can be trained to match your own voice and tone.

The conversation also explores the human side of a demanding career, from the challenges of being a single mother in this industry to navigating sobriety in professional settings.

Tune in for a fascinating look at the intersection of AI, healthcare, and what it truly means to be human in our industry.

Chapters:

(00:00:00) Making Healthcare More Human...Using AI

(00:01:09) The One Thing AI Still Can't Do

(00:04:36) Understanding "The Question Behind the Question"

(00:26:02) The Future of "Hyper-Personalized" Healthcare

(00:37:07) Using AI to Lower Prescription Costs

(00:50:12) Balancing a Demanding Career and Family

(01:02:32) Navigating Sobriety in the Benefits World

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"Good entrepreneurs fall in love with their solution and their platform, but great entrepreneurs fall in love with the problem." - Matt Scovil

Matt Scovil and Nathan Gilchrist of Medefy Health, have fallen in love with one of the biggest problems in benefits: nobody wants to engage with them. They joined the show to discuss their journey of building a platform designed to solve the engagement crisis and simplify the healthcare experience for everyone.

Matt and Nathan break down their "bottoms-up" approach to this problem, which focuses on engaging members when they need help through a high-touch, live support model delivered via mobile app. We discuss how they use the psychology of "loss aversion" and constant communication to drive engagement rates over 90%.

We also explore how Medefy acts as the "quarterback" for a health plan, removing friction by navigating members to the right solutions. This is all part of their vision for the future of healthcare, where the experience is "heavily, heavily individualized" for each person.

Chapters:

(00:00:00) Why Employees Would Rather Clean a Toilet Than Use Their Benefits

(00:04:18) Cleaning a Toilet vs. Learning Your Benefits

(00:08:46) Falling in Love with the Problem, Not the Solution

(00:14:23) The Power of Live, Human Support

(00:19:08) Using "Loss Aversion" to Drive Engagement

(00:34:54) The Quarterback for Your Health Plan

(00:47:57) How AI is Augmenting the Human Touch

(01:00:01) The Future of Healthcare is "Individualized"

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"I think the three strongest words that you can use as a leader, as a salesperson, as a client relationship person is I don't know." - Scott Milson

My guest this week, 35-year industry veteran and author Scott Milson, joins the show for a deep dive into the mindset required for a long and successful career. We discuss his journey from a self-described "career B student" to a partner at a major firm, and the lessons he learned about loyalty, hard work, and what it truly means to be excellent.

Scott breaks down his personal playbook for "tuning into the frequency of excellence." He shares his "Be 5 Framework" (Be Present, Curious, Intentional, Bold, and Reflective) and explains why embracing discomfort, adopting a growth mindset, and learning through informal mentorship are crucial for professional growth.

It’s worth noting that Scott is also professionally in the benefits industry, so I wanted to have him on the show to directly speak to those in this space.

I hope you'll tune in for this insightful conversation!

Chapters:

(00:00:00) Tuning Into The Frequency Of Excellence

(00:20:08) Why Discomfort is the Path to Growth

(00:21:56) The 3 Words That Defeat Imposter Syndrome

(00:27:52) The "Success to Significance" Curve

(00:38:42) The “Be 5” Framework for Excellence

(00:40:52) The Myth of Formal Mentorship

(00:48:25) "How You Do Anything is How You Do Everything"

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"We spend about $528 billion a year fixing the mistakes we make with medicines." - Chris Grilli

Fixing healthcare's $528 billion dollar mistake starts with ending the "trial-and-error" prescribing that plagues our system. My guest this week, pharmacist and genomics expert Chris Grilli of RxMapper, joined the show to explain how personalized, DNA-guided medicine is the key to solving this massive problem.

Chris breaks down the RxMapper model, explaining how they analyze 36 million data points from a patient's genome to provide medication recommendations with nearly 90% accuracy. We discuss the crucial difference between genetics and genomics, and how this approach saves thousands of dollars per patient while dramatically improving outcomes.

The mission to fix this problem is also a personal one. Chris shared the story of how his grandmother's preventable death from an adverse drug event became the inspiration for building RxMapper to ensure other families don't suffer the same fate.

Tune in this week for the playbook on fixing one healthcare's most expensive mistakes.

Chapters:

(00:00:00) Fixing Healthcare's $528 Billion Dollar Mistake

(00:02:12) The $528 Billion Cost of Medication Errors

(00:04:43) Genetics vs. Genomics: What's the Difference?

(00:10:29) Are Doctors Prescribing "Poison?"

(00:14:18) The Personal Story Behind RxMapper

(00:27:17) Saving Over $8,600 Per Patient

(00:41:24) How Your DNA Impacts Ozempic's Effectiveness

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"There's a big difference for me in living and being alive. There's a difference between breathing and truly experiencing life." - Todd Whitthorne

My guest this week Todd Whitthorne joined me for a conversation that goes far beyond the balance sheet to explore the true meaning of well-being. We discuss why a leader's personal health is the foundational, non-negotiable asset for their professional success.

Todd breaks down the crucial role leaders play in building trust and creating a "culture of health" that yields a real financial, clinical, and cultural ROI. We explore the five pillars of well-being (fitness, nutrition, sleep, stress, and prevention), the difference between "lifespan" and "healthspan," and why investing in yourself is the least selfish thing a leader can do.

The episode concludes with the incredible true story of Todd's 70-year-old friend who survived being hit and run over by a drunk driver, which is a powerful testament to how a lifelong commitment to fitness creates true resilience. I hope you’ll tune in for this inspirational conversation!

Chapters:

(00:00:00) Lessons in Health & Leadership

(00:06:11) Why Trust is a Leader's Most Important Asset

(00:14:14) The Difference Between Lifespan and Healthspan

(00:17:06) Why Investing in Yourself Isn't Selfish

(00:48:59) The Pursuit of True Happiness

(01:05:49) The 70-Year-Old Who Survived And Thrived After a Hit-and-Run

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"Understanding how an underwriter thinks and how they manage risk allows you to create a solution that actually creates impact and change for the long term." - Bobby Stuart

This week on the show, I'm joined by Bobby Stuart, a benefits consultant with Hotchkiss Insurance, for a deep dive into the mindset of a modern, forward-thinking advisor. We discuss his journey into the industry and what it takes to guide employers through the complexities of self-funding.

Bobby also broke down his playbook for creating long-term value for his clients. We explore why learning to "think like an underwriter" is a crucial skill for managing risk, the importance of simplifying complex ideas for employers, and why mastering the industry's language is the first step to finding simple solutions.

We also discuss how these strategies translate into real-world results, including how Bobby's team uses direct contracts and early intervention to help members get high-cost cancer care for free, removing the financial burden so they can focus on their health.

Chapters:

(00:00:00) How To Think Like An Underwriter (And Why It’s A Game-Changer)

(00:04:03) Overcoming the Complexity of Self-Funding

(00:04:59) Learning to Speak the Language of Insurance

(00:08:49) The Power of Thinking Like an Underwriter

(00:18:48) How To Stay Optimistic As A Benefits Consultant

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"The balance bill came in, it was 37 grand for this member, and we were able to get that thing fully wiped." - Patrick Haig

My guest this week, Patrick Haig, Co-Founder of Goodbill, has built a company designed to find errors in medical bills and fix them. From upcoding to time-based discrepancies, these inaccuracies cost health plans and their members a fortune.

In this episode, Patrick breaks down the Goodbill model. We discuss how their technology integrates directly with health plans to audit claims for errors before they're paid, and why that “upstream” approach is so game-changing. We also dive into one of their most powerful tools: the underutilized 501(r) IRS rule that can wipe out bills entirely, even for six-figure income families.

This episode is personal for me, as Patrick's team fixed my own son's ER bill, saving almost $1,000. I hope you’ll tune in!

Chapters:

(00:10:22) How DPC inspired Goodbill

(00:23:03) The 501(r) Secret: Hospital Financial Assistance

(00:27:15) How Upcoding Inflates Your ER Bill

(00:38:29) The Art of Negotiating a Hospital Bill

(00:48:43) Why "Upstream" Claim Auditing is a Game-Changer

(00:59:29) Can a Six-Figure Family Qualify for Assistance?

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/